Pennsylvania, Delaware, and Arkansas will have more control over their exchanges
Three states have been granted conditional approval from the federal government to play a larger role in the health insurance exchanges that they established through the Affordable Care Act. Arkansas, Delaware, and Pennsylvania will expand their role in their insurance exchanges beginning in 2016. Currently, the federal government operates the exchanges in these states. Some of the exchange’s functions are managed by the states themselves, but the majority of operations are handled by the federal government through HealthCare.gov and other organizations.
Insurance subsidies are at risk
This move may be in response to a potential ruling from the Supreme Court, which may have a major impact on the subsidies that are offered for those purchasing coverage through insurance exchanges. The Supreme Court is expected to deliver a ruling on the King v. Burwell case within the coming weeks. Currently, the federal government offers subsidies that can offset the cost of health insurance coverage purchased from exchanges. Depending on the ruling from the Supreme Court, these subsidies may no longer be available in federal exchanges.
States move to ensure that subsidies will remain available for consumers
States have been working on a solution to this problem, as the lack of subsidies would make insurance coverage unavailable for many people. The King v. Burwell case calls into question whether or not the federal government can provide subsidies in exchanges that it manages. The provisions of the Affordable Care Act make subsidies available in state-run exchanges. States without their own exchanges could lose access to subsidies, which may mean than many thousands of people will lose their insurance coverage.
States continue to seek solution to the possible conclusion of King v. Burwell case
Some states are preparing for the ruling from the Supreme Court by expanding their role in exchanges. Others are working to further expand their Medicaid program. Playing a larger role in exchanges may be a step toward managing a state-run exchange, which would secure subsidies for those that currently benefit from them and make insurance coverage more accessible to consumers.